Dominique Alexis Jackson, PMHNP-C - Nurse Practitioner in Hermanville, MS

  1. Home
  2. Nurse Practitioner
  3. MS
  4. Hermanville
Dominique Alexis Jackson, PMHNP-C is a Nurse Practitioner - Psychiatric/mental Health based in Hermanville, Mississippi. Dominique Alexis Jackson is licensed to practice in Mississippi (license number 906979) and her current practice location is 1035 Courtney Rd, Hermanville, Mississippi. She can be reached at her office (for appointments etc.) via phone at (601) 617-9659.

NPI number for Dominique Alexis Jackson is 1487487864 and her current mailing address is 1035 Courtney Rd, Hermanville, Mississippi. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1487487864.

Contact Information

Dominique Alexis Jackson, PMHNP-C
1035 Courtney Rd,
Hermanville, MS 39086-7700
(601) 617-9659
Not Available

Map and Direction




Provider's Profile

Full NameDominique Alexis Jackson
GenderFemale
SpecialityNurse Practitioner - Psychiatric/mental Health
Location1035 Courtney Rd, Hermanville, Mississippi
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1487487864
  • Provider Enumeration Date: 08/22/2024
  • Last Update Date: 09/26/2024

Medical Identifiers

Medical identifiers for Dominique Alexis Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1487487864NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LP0808XNurse Practitioner - Psychiatric/mental Health 906979 (Mississippi)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dominique Alexis Jackson is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dominique Alexis Jackson, PMHNP-C
1035 Courtney Rd,
Hermanville, MS 39086-7700

Ph: (601) 617-9659		Dominique Alexis Jackson, PMHNP-C
1035 Courtney Rd,
Hermanville, MS 39086-7700

Ph: (601) 617-9659

Reviews and Comments


Nurse Practitioner Nurses in Hermanville, MS

Latori Diane Wilson Roberts, NURSE PRACTITIONER
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 6020 Shelby Rd, Hermanville, MS 39086
Phone: 601-529-3390    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.